Best Obamacare Replacement

Top 10 Obamacare Replacement Solutions

Repeal and Replace Obamacare? The Top 10 Solutions to Implement in 2017 via

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Unfortunately, when the Affordable Care Act (also known as Obamacare) was designed it never addressed the reasons for the rising costs of health care in the under 65-year-old market [pre-Medicare]. Instead, this law simply exacerbated the inefficiencies inherent in the health care and insurance industries via taxpayer subsidies, thus masking the problems while the underlying costs skyrocketed. The law created many additional problems causing it to be unsustainable and destined to self-destruct.

Best-Business-Practice Health Care Solutions

The best-business-practice fixes to the U.S. health care system are obvious but have always been blocked by existing medical, legal, insurance, pharmaceutical and health care lobbyists that manipulate politicians in all parties to maintain the status quo. So, you MUST get this message to your politicians and demand that they implement these benefits immediately. 

The Top 10 Health Care Solutions

While there are simple fixes for each of the dozens of flaws in the current U.S. health care system, there are ten (10) basic solutions that we must implement right now:

1. Tax Deductions for 100% of all Health Care, Health Insurance and Health Maintenance Costs: Every American in the USA MUST be allowed to have a Health Savings Account (HSA) and accompanying debit card. All HSA expenses MUST be tax deductible. Then, all health care costs can be processed and accounted for via HSA debit card transactions to include:

➤ All costs for health, dental, vision, chiropractic, alternative medicine and other health care treatments

➤ All health, dental and vision insurance premiums and discount health care program costs

➤ All pharmaceutical drug costs

➤ All durable medical equipment costs

➤ All medical supply costs

➤ All preventative health maintenance costs

HSAs for Total Health Care Accounting

Just like current debit cards can separate out specific types of purchases on statements and accounting systems, HSA debit cards can separate out and categorize specific types of care (health, dental, vision, etc.) for respective insurance plans to easily account for care received and thus accounting toward deductibles. Standardizing templates for HSA debit card accounting fields and subsequent statements will translate into efficiencies for consumers, insurance companies and government entities that provide medical care programs like Medicare, TRICARE, VA, State Agencies, etc.

Political Action. Many politicians refuse to allow 100% of all consumer medical costs to be tax deductible. This must change NOW, and it can! We all must contact our political representatives and demand it. Like employer tax deductions, ALL individual and family health, dental and vision insurance premiums and ALL direct out-of-pocket health care costs MUST be tax deductible.

2. Lower Costs for Physician Care: Third-party insurance and government systems raise the costs for routine physician care due to the bureaucratic costs to administer such programs. It is common sense to remove these costs in the new consumer-focused health care system.

Direct Primary Care: This innovative concept eliminates the need for insurance companies or government agencies in primary care. HSA debit cards will be used to pay local doctors directly for the care provided. Without the excessive third party costs, doctors are able to have low office visit charges that are far less expensive and less of a headache for health care consumers and doctors than dealing with insurance or government intermediaries. 

Low-Cost Cash-Based Physician Practices
Direct Primary Care

Direct Primary Care via Concierge Medicine Memberships: Some practices allow patients to pay a monthly or annual membership fee for unlimited office visits. The fee typically covers annual physicals and routine maintenance care plus discounted other acute and chronic care. These practices are called Concierge Care. Watch this brief video to learn more.

Monthly Membership Plans
Concierge Medicine

3. Lower Health Care Costs for Preexisting Conditions: Most people with preexisting conditions need monthly access to doctors for maintenance care and for prescription refills. Since Direct Primary Care and Concierge Medicine cuts out third-party insurance and government bureaucracies, this can be an excellent low-cost addition to health care plans for people with preexisting conditions. For those with more extensive treatment requirements on a continual basis, see further below for solutions including state and federal programs.

Choose Your Own Doctor

Currently, insurance plans restrict consumers to "in-network" doctors. Many doctors are refusing to participate in a greater number of insurance networks. With Direct Primary Care and Concierge Care, all of us will be able to choose the doctors we want as our primary care and specialist providers.

A Healthier Nation

Easier and low-cost access to doctors can result in a healthier population thus reducing aggregate health care costs as a nation. Doesn't it make sense to be proactive and focus on maintaining quality health for all rather than being reactive and providing expensive care for a less healthy citizenry after major illnesses occur? 

4. Catastrophic Care Health Insurance: The current overwhelmingly expensive Obamacare Health Insurance plans will convert to relatively inexpensive insurance for Emergency, Catastrophic, Surgical and Hospital Care. This type of insurance is very low cost, but highly effective. It will only be used once deductibles are met as tracked by HSA debit cards. 

5. Portability: Obamacare reduced the number of insurers in most areas of the nation with many people having only one or two to choose from. Without competition, there is no pressure for reducing costs. Allowing health insurance companies to provide plans nationwide will ensure full competition that will naturally force prices lower for health insurance premiums. This will also allow insured members to move freely throughout the USA without having to change insurers. This is already done with life insurance and premiums in this category have seen large decreases recently.

Transition to Individual Plans

Employers can convert to facilitators of individual health insurance plans and pay employees more salary to cover the costs of health benefits. If congress approves this plan, insurance companies can offer their plans nationwide, health insurance consumers will not need to find new plans when they move from state to state or employer to employer. 

Health Care and Health Insurance at Lowest Costs: So, routine medical care will be provided at the lowest costs via Direct Primary Care while providing superior routine care, and the insurance portion of U.S. health care will be at the lowest costs also while covering all major health events.

6. Targeted Taxes to Help Fund State Insurance Pools. There are products in the alcohol, food and other consumer marketplaces that "cause" a tremendous amount of illnesses and thus skyrocket health care costs for everyone. Cigarettes and other tobacco products are major contributing factors to a long list of diseases and cause poor health for millions. Politicians have increased taxes on these products to crushing levels; however, the funds go into general revenues. The taxes should be redirected toward high-risk pool insurance funds in every state to help those living in poverty with pre-existing conditions to be able to afford health care.

Other consumer goods also cause higher incidents of many illnesses. Again, "sin taxes" imposed on other products like alcoholic beverages, and now even foods containing processed sugar and high fructose corn syrup, etc., should likewise be used strictly to help States fund health programs for those in poverty. This is not a statement on whether these types of taxes are appropriate or not, but only that if these types of taxes are imposed it is important to direct these specified tax revenues to address the related health problems caused by these products. A side benefit of this may be more healthy products introduced into the marketplace and also an awareness of the less healthy choices.

7. Prescription Drug Cost Savings: Currently many rely on insurance companies to help them pay their pharmaceutical drug costs. But the premiums for insurance plans that offer Rx benefits are typically higher, and then there are STILL co-pays for each drug purchased. FREE Discount Rx programs are available that many times provide the most popular prescriptions at around the same price as paying via insurance. In many instances, Discount Rx cards provide even better cost savings over insurance Rx co-pays. These Discount Rx programs negotiate competitive prices based on volume and pass the cost savings on to consumers. 

Generic Drug Cost Savings: In many instances, there are generic drug solutions that are a fraction of the cost of similar "brand" or "specialty" drugs. Quite often doctors prescribe expensive brand or specialty drugs when inexpensive generics are available. It must become standardized practice throughout the USA for all doctors to try generic drug solutions before the more costly options are introduced.   

Allowing Global Drug Purchasing: Pharmaceutical drug consumers in the United States pay the highest drug prices in the world. Other countries force drug companies to offer lower prices, but pharmaceutical company lobbyists manipulate politicians in the USA to keep their drug costs high for U.S. consumers. This is typically not an issue for generic drugs due to competitive pressures, but brand and specialty drugs are a very big problem. Allowing the purchase of pharmaceutical drugs from anywhere in the world will cause competition and thus drastically decrease prices in America. This has been tried several times before but the pharmaceutical lobbyists influence politicians to vote against such important measures.

Fixing the FDA

The excessive bureaucratic inefficiencies inherent in the Food and Drug Administration (FDA) that cause long delays for new drugs (including generics) to get to the marketplace must also be addressed. Millions of people have gotten sicker and even died while waiting for the FDA to take action on new drugs. Streamlining the FDA will solve many problems. It is imperative to contact our politicians and demand that they fix the many problems with the FDA and also allow international purchasing of quality pharmaceutical drugs.

8. Price Transparency: Currently, prices for health care are masked because insurance companies or government agencies typically pay much of the costs for care. It has been widely reported that there is extensive fraud, waste and abuse within these third party systems. Some estimates are that $100 billion in fraud is committed every year just in the Medicare marketplace alone and $250 billion annually in the insurance industry. Waste and abuse due to inefficiencies inherent in these bureaucratic third party systems may account for an equally shocking dollar amount.

Excessive pricing is also common in third party health care systems and all of these inefficiencies and excessive costs are passed on to health care consumers and taxpayers. Health consumers now see these outrageous costs on bills received for care because many people must pay out-of-pocket high deductibles up to $7,000 or more before full insurance benefits begin.

Standardized Health Care Price Lists: Standardizing health care price lists allows for the easy creation of databases and subsequent price comparison lookup tools for websites so consumers can shop for primary health care, specialty health care, dental, vision and other health services and know what they will pay for each service before making an appointment. Price lists will include costs for office visits and each type of care offered by each respective medical, dental, vision and other health care provider. This is already common practice among the Direct Primary Care and Concierge Medicine practices, so again it is a proven concept.

Standardized Health Insurance Price Lists: Additionally, standardizing health, dental and vision insurance price lists allows insurance agents to more easily shop among many carriers that will offer the same benefits. Databases can be linked to insurance agency and insurance broker platforms, so finding the right plans according to each specific client's needs will become a more exact science. 

9. Standardizing Insurance Modules (Riders): Allowing insurance consumers to purchase insurance plans and add standardized insurance modules (riders) according to their choices is vitally important to keeping insurance costs lower, competitive and able to be tailored to individual budgets and needs. Standardizing insurance module coverage types, amounts of coverage offered, included and excluded claim types and naming conventions for all associated terminology will also make it easy for side-by-side comparison.

Since there is no current standardization in the insurance industry and the fine print in insurance contracts is difficult to understand. Many times even employees of health insurers find it difficult to understand their own products when questioned for details. Quite often consumers get confused and don't understand their policies either, thus causing excessive out of pocket expenses for care received that his not covered by their plans. Simplification must be the goal with this standardization initiative. This too will drastically reduce costs as claims will be made easier and insurance company bureaucracies can be minimized.  

10. Stop Federal Involvement, Restrictions and Tax Penalties: The current Affordable Care Act law imposes a "federal" penalty known as the "Shared Responsibility Provision" that requires every American to have health insurance or pay a tax penalty collected by the IRS. Additionally, the federal government imposes thousands of pages of restrictions, regulations and exclusions on all employers and individuals that have skyrocketed premium costs for most.

The Shared Responsibility penalty is unfair in many ways. A major problem is that people that do have high-quality health insurance plans BUT are NOT "Obamacare" plans still pay the penalty just like someone that is uninsured. Again, insured people pay the same fine as uninsured people if the health insurance plans are NOT Obamacare-type plans. A large number of people choose these low-cost non-Obamacare plans AND to pay the penalty. Many STILL save thousands of dollars annually on health insurance premiums. This shows how excessively expensive Obamacare plans are in many areas.

Pay to Be Legally Uninsured: Many younger and or healthier people are forced to pay the Shared Responsibility penalty rather than pay the high costs of "Obamacare-approved" insurance plans. Essentially, they pay the federal government to be legally uninsured. This exposes them to penalty costs and potentially high catastrophic health costs if a health crisis occurs.

Obamacare Causes Less Healthy Insurance Pools: The tax penalty collected by the IRS goes into general revenues of the federal government and does not help the "Risk Pools" of the insurance industry. So, the original plan that younger and healthier people will help fill insurance company "reserves" with plenty of money is NOT working. The federal government makes the money on the penalty and insurance companies are left to manage a less healthy risk pool without adequate revenues. This is the reason why so many health insurers left the majority of markets across the nation. They were losing millions of dollars due to the average "adverse selection" of their less healthy policyholders. 

$42.6 Billion Cost to Taxpayers: Please note that the majority of people under the age of 65 in the USA receive health insurance from their employers. Many of the millions that live in poverty receive assistance via Medicaid. For those in the individual marketplace that are not covered by these other plans, Obamacare is mandatory. 

These "Affordable Care Act (ACA)" plans are ONLY affordable if tax subsidies make it so. About 80% of those in the individual market will receive some sort of subsidies. Some may receive only a few dollars monthly and others on the lower income scale will receive subsidies for almost all of their premiums. Overall, subsidies will cost taxpayers $42 Billion in 2017. 

Send it Back to the States: States have the responsibility of enforcing mandatory auto insurance plans, so it makes sense for States to also enforce their own requirements for health insurance. It would make sense for states to require those that do not secure health insurance on their own to be automatically insured with high deductible catastrophic insurance via court ordered garnishing of wages. Insurance companies can provide special plans for this provision that will be low cost but prevent potential extensively high medical bills that taxpayers and consumers would otherwise pay for the uninsured that require hospitalization. This will stop the use by many of the uninsured on unfunded "emergency room" care for catastrophic events.

Low-Income Assistance: Implementing these 10 plans will slash health care costs for consumers, insurance companies and governments at the State and Federal levels. If the government is going to provide assistance to those with low income, isn't it a good idea to subsidize a revolutionary system that provides better outcomes at the lowest costs?

Contact Your Politicians

Please share this page with everyone you know, especially your political representatives.        

Consumer Driven Health Care

 Illustration of Potential Savings

The average family health insurance premium is approximately $833 monthly or about $10,000 annually; PLUS, deductibles in 2017 can be $7,000+ per individual and $14,000+ for families. So, in addition to the $10,000 per year in premiums, the family runs the risk of charging up to an additional $14,000 in medical costs before full insurance kicks in.

A family catastrophic plan with the same deductibles may be around $300 monthly.

This leaves approximately $533 monthly that can be placed into their HSAs and be deducted from income taxes. These funds can be used to pay routine medical expenses. Unused funds will roll over to be used in future years. A tremendous amount of HSA funds can be saved during younger years for use throughout life and into elderly years, all while enjoying tax deductions on HSA contributions. Imagine in future years where millions of retiring senior citizens have hundreds of thousands of dollars in their HSAs. This could be a reality.

➤ In this illustration, it is clear that the current system is extremely expensive and health care consumers are forced to self-insure themselves for up to $7,000 per individual and up to $14,000 per family to cover deductibles. The best-business-practice solutions presented in this illustration returns approximately $533 monthly of those excessive health insurance premiums back to consumers to be used to cover out-of-pocket expenses.

In general, we should aim to drive premium costs down for individual insurance premiums to $50-$100 or less per month and $150-$300 or less per month on average for families depending on size. Then we should work to encourage fully funding HSA accounts by everyone. Incentives should be incorporated to make HSAs inheritable on a tax-free basis to fund the HSAs of any designated beneficiary. Currently, only spouses receive this benefit. Other incentives can be introduced later to make HSAs attractive to all. 

Easy Health Care Solutions

There are dozens of other easy fixes and a few solutions that require more work to perfect our health care system, but these ten (10) provide the 80% solution that can be implemented immediately and will benefit all. Again, please send this to your politicians and tell them that you want this in your health care plan.

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